Abstract
BackgroundSeveral inflammation-based prognostic scoring systems, including Glasgow Prognostic Score (GPS), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been reported to predict survival in many malignancies, whereas their role in metastatic nasopharyngeal carcinoma (NPC) remains unclear. The aim of this study is to evaluate the clinical value of these prognostic scoring systems in a cohort of cisplatin-based treated patients with metastatic NPC.MethodsTwo hundred and eleven patients with histologically proven metastatic NPC treated with first-line cisplatin-based chemotherapy were retrospectively evaluated. Demographics, disease-related characteristics and relevant laboratory data before treatment were recorded. GPS, NLR and PLR were calculated as described previously. Response to first-line therapy and survival data were also collected. Survival was analyzed in Cox regressions and stability of the models was examined by bootstrap resampling. The area under the receiver operating characteristics curve (AUC) was calculated to compare the discriminatory ability of each scoring system.ResultsAmong the above three inflammation-based prognostic scoring systems, GPS (P<0.001) and NLR (P = 0.019) were independently associated with overall survival, which showed to be stable in a bootstrap resampling study. The GPS consistently showed a higher AUC value at 6-month (0.805), 12-month (0.705), and 24-month (0.705) in comparison with NLR and PLR. Further analysis of the association of GPS with progression-free survival showed GPS was also associated independently with progression-free survival (P<0.001).ConclusionsOur study demonstrated that the GPS may be of prognostic value in metastatic NPC patients treated with cisplatin-based palliative chemotherapy and facilitate individualized treatment. However a prospective study to validate this prognostic model is still needed.
Highlights
Nasopharyngeal carcinoma (NPC) is a distinct disease with unique ethnic and geographic characteristics, whose incidence varies from 0.5–3/100 000/year in North Africa to 20–30 in some areas of southern China. [1,2] the cure rate has been significantly improved owing to advances in diagnostic imaging, radiotherapeutic techniques and chemotherapy regimens recently, distant metastases remain the main reason for failure of treatment
These include a combination of neutrophil and lymphocyte counts as the neutrophil to lymphocyte ratio (NLR) and a combination of platelet and lymphocyte counts as the platelet to lymphocyte ratio (PLR), both of which reflect full blood count derangements induced by the acute phase reaction, while the Glasgow Prognostic Score (GPS) incorporates raised circulating C-reactive protein (CRP) and hypoalbuminemia. [11,12,13,14,15] Recently some researches have shown that markers of systemic inflammatory response represent reliable prognostic factors in patients with early nasopharyngeal carcinoma
[23] Plasma Epstein–Barr virus (EBV) DNA has been identified to be prognostic in metastatic nasopharyngeal carcinoma (NPC) patients. [6,7] EBV infection stimulated the release of pro-inflammatory cytokine including IL-1, IL-6, and TNF-a from the tumor microenvironment, which results in the induction of CRP synthesis from the liver and the reduction of albumin by hepatocytes. [24,25] In
Summary
Nasopharyngeal carcinoma (NPC) is a distinct disease with unique ethnic and geographic characteristics, whose incidence varies from 0.5–3/100 000/year in North Africa to 20–30 in some areas of southern China. [1,2] the cure rate has been significantly improved owing to advances in diagnostic imaging, radiotherapeutic techniques and chemotherapy regimens recently, distant metastases remain the main reason for failure of treatment. [3] In these cases, palliative systemic therapy remains the primary therapeutic option and cisplatin-based combination chemotherapy is considered the standard front-line regimen for decades, offering response rates in the range of 50–80% and a significant prolongation of overall survival (OS). [4] there are still wide individual differences in clinical response and outcomes. [8,9,10] Several inflammation-based prognostic scoring systems have been devised and found to be strongly correlated with prognosis in patients with a variety of neoplasms These include a combination of neutrophil and lymphocyte counts as the neutrophil to lymphocyte ratio (NLR) and a combination of platelet and lymphocyte counts as the platelet to lymphocyte ratio (PLR), both of which reflect full blood count derangements induced by the acute phase reaction, while the Glasgow Prognostic Score (GPS) incorporates raised circulating C-reactive protein (CRP) and hypoalbuminemia. We evaluated the clinical value of several inflammation-based prognostic scoring systems including GPS, NLR and PLR in a cohort of cisplatin-based treated patients with metastatic NPC. Several inflammation-based prognostic scoring systems, including Glasgow Prognostic Score (GPS), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been reported to predict survival in many malignancies, whereas their role in metastatic nasopharyngeal carcinoma (NPC) remains unclear.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
